1. Field of the Invention
The present invention relates to an apparatus for applying one or more suture clips to a suture during endoscopic and/or laparoscopic surgical procedures or open procedures.
2. Background of the Art
In surgical operations it is often necessary to apply suture retaining clips to sutures. Various clips for holding a suture in a serpentine fashion are disclosed in U.S. Pat. No. 5,282,832, which is herein incorporated by reference in its entirety. What is needed is an instrument for applying such serpentine suture clips during a laparoscopic and/or endoscopic surgical procedure.
In laparoscopic procedures surgery is performed in the interior of the abdomen through a small incision; in endoscopic procedures surgery is performed in any hollow viscus of the body through narrow endoscopic tubes inserted through small entrance wounds in the skin. Often, a small puncture wound is made with a trocar and a cannula is inserted therethrough. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e., provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic or endoscopic incision as, for example, in surgical procedures in which the surgical region is insufflated. Thus, when the apparatus employed for operations at an insufflated surgical site, the apparatus must be provided with an internal sealing means to prevent passage of gas or other fluids through the interior of the apparatus. Moreover, there should be a seal between the apparatus and the cannula through which it is inserted. The sealing means permits the mechanical movement of the apparatus or its parts while preventing the leak of fluids at the loci of sliding movement. Sealing may be accomplished by closely controlling the dimensional tolerance of the parts during manufacture to insure a close fit, and by the use of viscous sealing gels. Optionally, a sealing block may be employed to provide a seal. Use of a sealing block is disclosed in U.S. Pat. No. 5,100,420, herein incorporated by reference. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues, and vessels far removed from the incision, thereby requiring that any instruments to be used in such procedures be both long and narrow.
The terms "endoscopic" and "endoscopic portion", among others, as used herein encompass both laparoscopic and endoscopic procedures and refer generally to instruments having elongated and relatively narrow operating portions for inserting into a cannula or a small wound in the skin. These terms should not be construed to limit the present invention to an apparatus for applying suture clips only in conjunction with a cannula. To the contrary, it is believed that the present invention may find use in any procedure where access is limited to a small incision.